Portal de investigação
Spironolactone effect on circulating procollagen type I carboxy-terminal propeptide: Pooled analysis of three randomized trials
Data de publicação:
Data Ahead of Print:
Autores da FMUP
Participantes de fora da FMUP
- Cleland, JG
- Girerd, N
- Rossignol, P
- Pellicori, P
- Cosmi, F
- Mariottoni, B
- González, A
- Diez, J
- Solomon, SD
- Claggett, B
- Pfeffer, MA
- Pitt, B
- Petutschnigg, J
- Pieske, B
- Edelmann, F
- Zannad, F
Unidades de investigação
Abstract
Background: Spironolactone might improve the prognosis of patients with heart failure with preserved left ventricular ejection fraction (HFpEF), but the mechanisms by which it acts are uncertain. Serum concentrations of procollagen type I carboxy-terminal propeptide (PICP) reflect the synthesis of type I collagen and correlate well with histologically proven cardiac fibrosis.Aims: To investigate the effect of spironolactone on serum PICP concentration in patients with stage B and C HFpEF across three trials (HOMAGE, ALDO-DHF, and TOPCAT) for which measurements of serum PICP were available.Methods: Random-effects meta-analysis.Results: A total of 1038 patients with PICP measurements available both at baseline and 9-12 months were included in this analysis: 488 (47.0%) from HOMAGE, 386 (37.2%) from ALDO-DHF, and 164 (15.8%) from TOPCAT. The median (percentile25-75) serum PICP was 98 (76-128) ng/mL. Compared to placebo or usual care, administration of spironolactone for 9 to 12 months reduced serum PICP by-7.4 ng/mL, 95%CI-13.9 to-0.9, P -value =0.02. The effect was moderately heterogeneous (I2 = 64%) with the most pronounced effect seen in TOPCAT where PICP was reduced by-27.0 ng/mL, followed by HOMAGE where PICP was reduced by-8.1 ng/ mL, and was least marked in ALDO-DHF where PICP changed by-2.9 ng/mL. The association between spi-ronolactone and serum PICP was not mediated substantially by blood pressure.Conclusions: Spironolactone reduced serum concentrations of PICP in patients with HFpEF with different severity and stages of disease. These findings are consistent with spironolactone having an anti-fibrotic effect.
Dados da publicação
- ISSN/ISSNe:
- 1874-1754, 0167-5273
- Tipo:
- Article
- Páginas:
- 86-88
- Link para outro recurso:
- www.scopus.com
International Journal of Cardiology Elsevier Ireland Ltd
Citações Recebidas na Web of Science: 2
Citações Recebidas na Scopus: 6
Documentos
- Não há documentos
Filiações
Keywords
- Spironolactone; Fibrosis; Anti -fibrotic therapy; HFpEF
Financiamento
Proyectos asociados
Dapagliflozin, Spironolactone or Both for HFpEF (SOGALDI-PEF) - NCT05676684
Investigador Principal: João Pedro Melo Marques Pinho Ferreira
Ensaio Clínico Académico (SOGALDI-PEF) . AstraZeneca . 2022
Citar a publicação
Ferreirra JP,Cleland JG,Girerd N,Rossignol P,Pellicori P,Cosmi F,Mariottoni B,González A,Diez J,Solomon SD,Claggett B,Pfeffer MA,Pitt B,Petutschnigg J,Pieske B,Edelmann F,Zannad F. Spironolactone effect on circulating procollagen type I carboxy-terminal propeptide: Pooled analysis of three randomized trials. Int. J. Cardiol. 2023. 377. p. 86-88. IF:3,500. (2).
